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Performance Feedback in Health Care

1 oktober 2020 uppdaterad av: Felipe Lobelo, Kaiser Permanente

The Southeast Permanente Medical Group (TSPMG) at Kaiser Permanente Georgia provides performance feedback to its providers. The performance feedback designs can vary and change over time in terms of targets, summary statistics, included measures, and frequency of delivery. The TSPMG health services research group seek to compare different performance feedback designs to identify which are most effective at contributing to performance improvement.

The research team will randomly assign providers into different performance feedback conditions, as specified in the protocol. Providers will receive performance feedback through the standard mechanism in which it is conveyed by their supervisor.

The objective is to investigate how to design performance feedback for providers to best motivate and support them in improving performance along with existing strategic priorities for care delivery.

The reserach team will test alternative designs of performance feedback that vary on the following dimension:

1) targets for comparison of one's own performance

Studieöversikt

Detaljerad beskrivning

The Southeast Permanente Medical Group (TSPMG) provides performance feedback to its providers. The performance feedback designs can vary and change over time in terms of targets, summary statistics, included measures, and frequency of delivery. The TSPMG health services research team will seek to compare different performance feedback designs to identify which are most effective at contributing to performance improvement. .

The research team will randomly assign providers into different performance feedback conditions, as specified in the protocol. Providers will receive performance feedback through the standard mechanism in which it is conveyed by their supervisor.

The objective is to investigate how to design performance feedback for providers to best motivate and support them in improving performance along with existing strategic priorities for care delivery.

The research team will test alternative designs of performance feedback that vary on the following dimension:

1) targets for comparison of one's own performance

The research team will provide feedback on performance by measures that the organization already tracks internally and uses for performance improvement. These include a provider's utilization of opportunities to provide flu vaccinations.

The study will randomly assign different designs of feedback to providers. In order to understand which designs of feedback have the best effects on performance, the research team will test the following hypotheses:

  1. Displaying the next-highest quartile will motivate improvement more than display of all quartiles.

    Theory: The next-highest quartile will serve as an injunctive norm, or suggested target, to repeatedly lift an individual's performance to the suggested level.

  2. The positive effect of displaying the next-highest quartile, relative to displaying all quartiles, will be most pronounced for initially low performers.

    Theory: The next highest quartile averts upward social comparison to a much higher level of peer performance, which can be discouraging and so negatively affect performance

  3. The positive effect of displaying the next-highest quartile, relative to displaying all quartiles, will diminish over time.

    Theory: Individuals may become worn out as they see a target ratchet higher when their performance improves.

  4. Displaying team relative performance along with individual relative performance will be more effective than displaying either type of information alone.

Studietyp

Interventionell

Inskrivning (Faktisk)

595

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

    • Georgia
      • Atlanta, Georgia, Förenta staterna, 30305
        • Kaiser Permanente Georgia Regional Offices

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Barn
  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Ja

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

A healthcare provider practicing at The Southeast Permanente Medical Group in a specialty for which the performance measure being studied is relevant.

Health care providers include:

Physicians, Nurse Practitioner, Certified Nurse Midwife, Psych Nurse Specialist, Optometrist, Podiatrist, and Physician Assistant

Exclusion Criteria:

Non-Physicians: Registered Nurses excluding nurse practitioners

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Hälsovårdsforskning
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Enda

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Aktiv komparator: Organizational Target
Providers are shown the flu success performance rate of their team (a "pod," or group of providers who practice together), in comparison to their own, and with the organizational target. These updates and targets are sent bi-weekly.

A given provider will be involved in the study for a maximum of 6 months. This will involve, at the most frequent, the delivery of weekly performance feedback.

The performance feedback will be delivered using standard approaches already in place in the organization and there will not be a period of seeking out participants for enrollment.

Providers will receive performance feedback bi-weekly for the duration of the study period.

Experimentell: Achievable Target
Providers are shown the flu success performance rate of their team (a "pod," or group of providers who practice together), in comparison to their own. They will receive a static and achievable target based on their previous year's flu vaccination success rate.

A given provider will be involved in the study for a maximum of 6 months. This will involve, at the most frequent, the delivery of weekly performance feedback.

The performance feedback will be delivered using standard approaches already in place in the organization and there will not be a period of seeking out participants for enrollment.

Providers will receive performance feedback bi-weekly for the duration of the study period.

Experimentell: Variable
Providers are shown the flu success performance rate of their team (a "pod," or group of providers who practice together), in comparison to their own. They will receive a variable target that will fluctuate bi-weekly, based on their previous bi-weekly flu vaccination success rate.

A given provider will be involved in the study for a maximum of 6 months. This will involve, at the most frequent, the delivery of weekly performance feedback.

The performance feedback will be delivered using standard approaches already in place in the organization and there will not be a period of seeking out participants for enrollment.

Providers will receive performance feedback bi-weekly for the duration of the study period.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Flu Vaccination Administered During Encounter
Tidsram: 10 Weeks
Whether or not the providers succeeded in administering flu vaccination during flu vaccination opportunity
10 Weeks

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

23 september 2019

Primärt slutförande (Faktisk)

31 december 2019

Avslutad studie (Faktisk)

31 december 2019

Studieregistreringsdatum

Först inskickad

9 september 2020

Först inskickad som uppfyllde QC-kriterierna

1 oktober 2020

Första postat (Faktisk)

8 oktober 2020

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

8 oktober 2020

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

1 oktober 2020

Senast verifierad

1 oktober 2020

Mer information

Termer relaterade till denna studie

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